Immigrant family, ca. 1900, nurse in black
In the 19th and early 20th centuries, patients with typhoid fever and other contagious diseases were often treated at home, not in hospitals. For those who could not afford doctors, the Visiting Nurse Association of Philadelphia offered care. In this photograph, the visiting nurse is in the black coat and hat.
In the years between 1860 and 1909, more than 27,000 Philadelphians died of typhoid fever, a highly contagious disease caused by the microscopic bacterium Salmonella typhi. Today we understand that typhoid spreads readily through contaminated food and water supplies and through direct contact with an infected person. The bacteria are transmitted most commonly through the fecal-oral route, so excrement from an infected person discharged directly into water supplies can infect a person who drinks that water.